Healthcare Provider Details

I. General information

NPI: 1891137188
Provider Name (Legal Business Name): NUNEC HOME HEALTHCARE SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/27/2013
Last Update Date: 07/27/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14520 FAIRDALE RD
SILVER SPRING MD
20905-6526
US

IV. Provider business mailing address

14520 FAIRDALE RD
SILVER SPRING MD
20905-6526
US

V. Phone/Fax

Practice location:
  • Phone: 240-643-5638
  • Fax: 240-560-6526
Mailing address:
  • Phone: 240-643-5638
  • Fax: 240-560-6526

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License NumberR3455P
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License NumberR3455P
License Number StateMD

VIII. Authorized Official

Name: MRS. NGOZI BERNADETTE AMADI-OBI
Title or Position: NURSING DIRECTOR
Credential: REGISTERED NURSE
Phone: 240-643-5638